Cancer Treatment May Affect Ocular Rosacea
Ocular toxicity is common during adjuvant therapy for early breast cancer and is largely the result of ocular irritation stemming from chemotherapy, a retrospective study suggests.
Ocular toxicity "may be disturbing" for women, investigators note in the February 1st issue of Cancer, and "may justify secondary preventive measures" for those women who develop ocular irritation after an initial cycle of chemotherapy.
By contrast, ocular toxicity during hormonal therapy with a selective estrogen receptor modulator (SERM) alone "seems rather rare," Dr. Lorenzo Gianni from Ospedale degli Infermi in Rimini, Italy and colleagues report, and, therefore, "does not appear to justify a regular program of ocular examination."
Nonetheless, "nurses and physicians should pay attention and inform patients about possible side effects for a prompt ocular evaluation in case of ocular complaints," Dr. Gianni said.
The research team culled data on the incidence and timing of ocular toxicity after adjuvant chemoendocrine treatment for early breast cancer in 4948 women from seven International Breast Cancer Study Group Trials conducted between 1978 and 1999. The women were randomized to receive endocrine therapy with a SERM (tamoxifen or toremifene) alone or with chemotherapy.
A total of 580 instances of ocular toxicity were reported in 538 women (10.9%) during adjuvant treatment, mainly during chemotherapy, Dr. Gianni and colleagues report.
Forty-five women (0.9%) had ocular toxicity during tamoxifen or toremifene therapy alone but only 30 (0.6%) of these cases were deemed possibly related to tamoxifen or toremifene.
"Impaired visual acuity, ocular irritation and cataract were the most frequent side effects, while no cases of confirmed retinopathy were reported," Dr. Gianni said.
In most cases, ocular toxicity developed within the first two months of treatment, with a plateau at the end of chemotherapy. In most of cases, ocular toxicity was no higher than Grade 1 (75%).
For a variety of reasons, it is "very likely that we have underestimated the incidence of ocular toxicity," the authors note in their report.
"The fear of ocular toxicity," Dr. Gianni concluded, "should not influence the (treatment) decision in most cases, but for patients with pre-existing ocular disease the use of an aromatase rather than tamoxifen may be appropriate, keeping in mind that aromatase inhibitors have not been as fully evaluated for ocular and other adverse events."
Ocular toxicity "may be disturbing" for women, investigators note in the February 1st issue of Cancer, and "may justify secondary preventive measures" for those women who develop ocular irritation after an initial cycle of chemotherapy.
By contrast, ocular toxicity during hormonal therapy with a selective estrogen receptor modulator (SERM) alone "seems rather rare," Dr. Lorenzo Gianni from Ospedale degli Infermi in Rimini, Italy and colleagues report, and, therefore, "does not appear to justify a regular program of ocular examination."
Nonetheless, "nurses and physicians should pay attention and inform patients about possible side effects for a prompt ocular evaluation in case of ocular complaints," Dr. Gianni said.
The research team culled data on the incidence and timing of ocular toxicity after adjuvant chemoendocrine treatment for early breast cancer in 4948 women from seven International Breast Cancer Study Group Trials conducted between 1978 and 1999. The women were randomized to receive endocrine therapy with a SERM (tamoxifen or toremifene) alone or with chemotherapy.
A total of 580 instances of ocular toxicity were reported in 538 women (10.9%) during adjuvant treatment, mainly during chemotherapy, Dr. Gianni and colleagues report.
Forty-five women (0.9%) had ocular toxicity during tamoxifen or toremifene therapy alone but only 30 (0.6%) of these cases were deemed possibly related to tamoxifen or toremifene.
"Impaired visual acuity, ocular irritation and cataract were the most frequent side effects, while no cases of confirmed retinopathy were reported," Dr. Gianni said.
In most cases, ocular toxicity developed within the first two months of treatment, with a plateau at the end of chemotherapy. In most of cases, ocular toxicity was no higher than Grade 1 (75%).
For a variety of reasons, it is "very likely that we have underestimated the incidence of ocular toxicity," the authors note in their report.
"The fear of ocular toxicity," Dr. Gianni concluded, "should not influence the (treatment) decision in most cases, but for patients with pre-existing ocular disease the use of an aromatase rather than tamoxifen may be appropriate, keeping in mind that aromatase inhibitors have not been as fully evaluated for ocular and other adverse events."
posted by Nick Riley at 12:18 PM
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